March 22, 2013 — It’s estimated that about five million children in India are addicted to tobacco. They’re lured in by small, brightly colored packs of chewing tobacco—very popular in India—that cost just pennies a pack and are available everywhere, often close to schools. Frequently, children start using chewing tobacco, then graduate to cigarettes as they get older.

To combat this trend, the Mumbai-based Salaam Bombay Foundation has offered innovative school-based programs since 2002 to steer kids away from tobacco use by engaging them in spirited anti-tobacco campaigns and helping boost their life skills and confidence through sports, arts, and cultural activities. Padmini Somani, Salaam Bombay’s executive director and founder, described the organization’s work in a talk at Harvard School of Public Health (HSPH) on March 5, 2013 to health communication students and faculty.

Kasisomayajula Viswanath, associate professor of social and behavioral sciences at HSPH, introduced Somani. With other HSPH colleagues, Viswanath has helped Somani evaluate Salaam Bombay’s programs. An April 2012 study published in PLOS ONE by Viswanath; Glorian Sorensen, professor of social and behavioral sciences at HSPH; Prakash Gupta, PD ’85, director of Healis-Sekhsaria Institute of Public Health in Mumbai; and Eve Nagler, SD ’10, a research scientist at Dana-Farber Cancer Institute, found that students enrolled in the foundation’s programs were half as likely as other children to start using tobacco.

Somani said tobacco is a huge health issue for India—roughly 25% of the population uses it. And there are challenges in effectively communicating tobacco’s dangers across the country because India is home to a wide variety of ethnic and cultural groups who speak 16 different languages.

“Tobacco equals death—so it should be an easy thing to communicate that, right?” she asked the audience. “The problem is that, in India, the word ‘tobacco’ doesn’t mean the same thing to different people.” Tobacco comes in many different forms in India, including cigarettes, smokeless tobacco, chewing tobacco, and raw tobacco. While many in India smoke “bidis” (hand-rolled cigarettes) or use “gutka” or “khaini” (forms of chewing tobacco), they don’t always understand that these products can harm their health, Somani said.

Since the initiation to tobacco products is occurring at younger and younger ages in India, Salaam Bombay focuses its efforts on children. And the best way to engage children, Somani said, is not to pepper them with dire warnings about tobacco’s negative health consequences, but to offer positive messages and activities instead.

“If it’s a negative message, they tend to shut it out,” she said.

So Salaam Bombay offers confidence-boosting programs, such as tips on how to handle peer pressure or how to deal with stress. Children participate in a sort of “super army” to fight tobacco, which gives them leadership skills focused on change. The kids perform street theater with anti-tobacco messages, attend anti-tobacco rallies, and search for violations of India’s laws outlawing tobacco advertising.

Children are also featured prominently in an exuberant anti-tobacco music video, produced by Salaam Bombay in association with India’s Ministry of Health and Family Welfare, starring the popular Indian singer Shaan. The video’s main message: “Life se panga mat le yaar!”—“Don’t mess with your life!”